Piercing Under Masks

As of today, Infinite Body Piercing’s Philadelphia location will begin joining our Baltimore studio in offering nostril and septum piercings. As vaccination becomes more of an option to a larger percentage of the population, and as COVID rates (and most importantly, fatalities) begin to slowly level off and decline, businesses everywhere are facing the same tough question: when do we relax our COVID-19 restrictions? With everything that went into our decision, we decided to share how we got here, with the hope that it will help others who are—or soon will be—wrestling with the same issue. This is how we decided we are now piercing under masks.

COVID-19 Services Update:

Effective April 2, 2021

• Nostril and septum piercing services are now being offered by appointment at both our Philadelphia and Baltimore locations. Masks should still remain on at all times while in the studio lobby. For nostril and septum piercings or jewelry changes, piercers will instruct clients when and how to pull down masks in the private piercing rooms.
• We are not currently offering any oral piercings and/or jewelry changes at either of our locations. This means no piercing services or jewelry changes in or around the mouth.
• Kids’ ear piercing services for children 8 to 12 years old are currently being offered, by appointment, at our Baltimore location only. We are still offering limited piercing services to clients thirteen years and older at our Philadelphia location.
• All other services are being offered by appointment at both our locations.

 

Book Appointment

 

When we announced at the new year that we would begin offering limited under-mask services (specifically nostril and septum piercings) at our Baltimore studio, there was  some discussion, along with criticism, of our decision in online forums and social media posts. Since many of our fellow industry peers (and other service industry businesses) are wrestling with similar questions, we thought this would be a good place to explain what went into our decision, as transparently as we can.

On March 16, 2020, everything came to a screeching halt. That morning, in light of reports of the spread of the COVID-19 virus and growing apprehension from the staff, we made the decision to close for what we thought would be a few weeks. Later that afternoon, Philadelphia announced the forced closure of all non-essential business in the City. Soon, the rest of the country was in various stages of a quarantine that would last for over three months. Three months with no income, save what we received from online sales.

When we closed, we continued to pay the salaries of the entire staff of fourteen. As the closure continued we stood by that decision, even without knowing how long we could afford to do so. We were approved for the first round of PPP funding, which covered six weeks of payroll, but the rest was pulled from our savings. Most of this was money put aside for our staff to attend the annual APP Conference, which was ultimately cancelled. I point this out not to get a pat on the back, but to acknowledge that we were fortunate to have enough put aside that we were able to take care of the staff—and not everyone had this luxury.

What are the rules?

During the closure, while we worked on our COVID-19 protocol for our anticipated reopening, we weren’t even sure if we’d be able to offer any service under masks. Ultimately, we were saved having to make this decision when Philadelphia announced reopening guidelines that prohibited all personal services on areas located under masks. With our hands full figuring out everything else, we postponed making plans for when and how we would offer these services again. And then, a few months later, that time was suddenly upon us.

Late October of last year, when I was preparing an update to our COVID protocol, I checked on the link to the original Philadelphia guidelines for personal services and found that they had changed. It now stated that we were able to offer services under the mask as long as the practitioner was wearing an N95 mask, a face shield, and gloves. When I reached out to the health inspector, I was told that they were not yet made aware of the change, but that their interpretation was that body art establishments could resume facial piercings where the mask would need to be removed temporarily. This is how we found ourselves suddenly and unexpectedly able to offer under-mask services in Philadelphia. No warning or advance notice, simply that we were now allowed to offer the service. What were we going to do?

Over the next two weeks we jumped into planning mode. Did we want to start offering nostril and septum piercings? What about oral piercings? How did our employees feel about it? How would working on partially-unmasked clients affect the risk of exposure to our staff and other clients? What additional PPE would we need? (And could we get it? And would it be effective?) Should we do things differently from one of our studios to the other?

We asked ourselves these and many more questions about the safety and logistics of making another major change to our normal operations. I spent several hours over several days talking with both my Operations Manager and Piercing Manager, discussing every side of the decision. While we sought input from everyone on the staff at both of our locations, there was clearly going to be no consensus. The issue, without universally accepted information on risks, was largely an emotional one. It became clear in the end that this would have to be a management decision.

We announced at our Friday meeting that we were going to start taking appointments for nostril and septum piercings in Baltimore, and would be offering jewelry changes on existing nostril and septum piercings in Philadelphia. Immediately after the meeting one of our counter staff employees quit, never to return. Less than an hour later, one of our Philadelphia piercers informed us that they would not be comfortable working on piercings located under masks until they had been vaccinated, knowing that this might mean the end of their time at the studio—but hoping to find some sort of workaround. While we expected some bumps in the road, both of these took us by surprise. Could we offer under-mask services (while required to work by appointment) and allow one of our piercers to skip all of these appointments? While dealing with the immediate effects of losing one of our full-time counter staff members without notice, we tried to answer these questions and prepare to make the change later on that day.

Later that same afternoon, as we agonized over how to move forward, it was announced that Philadelphia would be issuing an update that Monday (the day we had planned to start accepting these new appointments) on new business restrictions related to COVID. We postponed implementing any changes, and learned that following Monday that the city had reinstated the prohibition against under-mask piercings through the end of 2020. Again, our decision was made for us.

It was only a matter of about two weeks from the discovery that the guidelines had changed to their changing right back to prohibiting under mask services—two weeks filled with research, debate, and lots and lots of planning, all for naught. Though we aren’t privy to what goes on behind the scenes with the health department’s restrictions, it almost seemed like the original update might have been an error, a change made by one arm of local health services without the knowledge of another. While we didn’t end up implementing any updates at that time, going through this process forced us to do the work and research necessary to make this decision later on. It’s very true that the bigger the operation, the more difficult it is to steer the ship in another direction, against inertia.

But really, what are the rules?

It seems that everyone was—and still is—lacking guidance. There is little dispute that the Federal response to the pandemic has been, until recently, uninspiring. In the middle of the largest health crisis in our lifetime, we’re all looking for advice and not getting it. It’s no wonder that everyone is so polarized with the lack of effective top-down leadership. Everyone is looking to justify their own position, brace up their own moral decision on how they operate during the pandemic, and often that comes with criticizing what others do—and often attributing malicious intent along with it. We accuse others of prioritizing money over safety, as though it is a zero-sum equation.

Even when mandates are put forth by local governments they are met with skepticism at best. When newly elected Baltimore mayor Brandon Scott recently announced that restaurants would be reopening at limited capacity, at least one comment I saw on Facebook suggested that he was only doing so because of bribes from the restaurant industry—and not the fact that, barring more stimulus money, many of these restaurants would be going under if business was delayed any longer. Everyone is in desperate need of guidance, but are ultimately suspicious of that instruction when it does come.

The piercing industry is no different. Many have looked to the Association of Professional Piercers, calling for them to issue mandates on what services should and should not be offered by their members—and to police them into following these rules. (Spoiler: it’s not their mission to do so. I know; I was a board member in the organization from 2005 to 2011, with the last three years as its president.) Many online forums have bemoaned the lack of guidelines from their local health departments. While I would also welcome more guidance, I imagine everyone has their hands full with the rest of the pandemic. Everyone seems to be screaming into the void, “Please, won’t someone tell us what to do!” and hearing just silence in reply.

Where do we fit in?

At Infinite, we fall in a sort of “grey area” when it comes to COVID guidelines. We do offer what is defined as “personal services,” but we also have a healthcare element to what we do—yet are decidedly not “in the loop” with larger concerns within the larger healthcare industry.

The biggest difficulty we have had in making decisions about practices and protocol at the studio is the lack of information specifically addressing our industry and exactly what we do. Early on in the pandemic, as doctors and scientists worked to deduce transmission risks, it was revealed that not only was it exposure to the virus, but a prolonged enough exposure that transmitted enough of the virus for it to spread to a new host—that it’s not only exposure to the virus, but exposure with enough particles to infect. 

Since the initial shutdown was relaxed, it seems that most efforts to mitigate the risks of exposure have concentrated on environments that host large numbers of people for long periods of time (such as concerts and church services) and specifically maskless patrons (restaurants and bars). While retail has been restricted in most places to fractions of maximum capacity, not much has been published concerning the risks to those performing personal services—and almost nothing quantifying the risks of working with clients without masks if proper PPE is used.

So the big question still remained unanswered: how is the risk of performing under-mask services quantified? We were trying to weigh the benefits vs. the risk without reliable information on the risks.

What are the risks?

As an industry, we are incredibly familiar with the risk of bloodborne pathogens and cross contamination. We are certified in BBP training annually and many of us take additional courses each year on everything from the best practices in the piercing room to cross contamination prevention techniques. In fact, this training and knowledge actually put us ahead of the game at the start of the pandemic. Proper handwashing technique? No problem. Personal protective equipment? We’ve got it. We erred on the side of caution and implemented strict guidelines from the start, some that have been slightly modified or relaxed and others that remain in place to this day. But when it comes to airborne pathogens, especially for a virus that is brand new to the entire world, even we found it difficult to determine best practices for our particular industry.

Like dentists, piercers are physically close to our clients while working. But unlike dentists, most piercing services do not require minutes to hours of close contact with the client’s mask off. Ultimately we got the opportunity to ask an epidemiologist what the risk level is for body art practitioners during a conference of four Body Art Health Inspectors from the US. He said:

If the [client] is asymptomatic we would consider them to be not super-high risk if your operator is wearing a face shield and an N95 mask. That’s what we would recommend in a healthcare setting for a procedure that would be similar. When a clinician takes a swab for instance from [someone’s] throat for flu [...], if they have a face shield on, gloves on, and an N95 mask, they’re considered protected during that procedure. And when that procedure is over the [client’s] mask goes back on. From a medical standpoint we could argue that would be equivalent to what we’re seeing in dental offices, and medical settings.

He also mentioned that, yes, duration is a factor, but in our business, the time spent in close contact with a client is low, especially when compared to many dental procedures that can seem like they last forever. As far as risk goes, he recommended that the least amount of time a client can be unmasked the better, but “with proper PPE it’s hard to say that there is a valid exposure if someone is suited up to that degree.”

 

Uncertain Times

When we reopened in Philadelphia on June 26, we had no idea what to expect. After being a strictly walk-in studio for our entire twenty-five years, we were suddenly forced to be appointment-only. Not only did we need to vet appointment software, but we had to figure out so many staffing and safety questions as well. Medical supplies were now scarce and being rationed, and even to this day there are still limits in place for how much and how often we can order. Add to that we were at the tail end of preparing to open a new studio in Baltimore right when the pandemic hit. It wasn’t what we would have chosen, but here we are. While every decision made during this pandemic must first consider the health and safety of our staff and communities, we discovered that, unfortunately, economics and livelihood play into the discussion just as much—if not more.

When we were originally looking into doing under-mask piercings, we reached out to many different industry professionals: piercers and shop owners, and many who were both. What we found was that there were many practitioners offering under-mask piercings, and an equally large number of them were doing so because of the economics of the situation. Newer studios and less high-traffic studios offered the service to “keep the lights on” and keep employees paid, while other piercers lamented that the decision was made by someone in management, and they were bound to it. We didn’t want to make this solely an economic decision, but we can’t ignore the fact that it played a role in the process for everyone we talked to, even during our conversations with the staff.

Upon reopening our Philadelphia studio we were busy right from the start. Not pre-COVID busy, but busy enough that we had no worries about a lack of clients. In the beginning, our appointments filled up almost two weeks in advance. We were seeing case numbers in our area go down for a few months, but when they began to climb again as we approached Winter business slowed down. While our Philadelphia staff did feel the slowdown in business, we stayed busy enough and continued to have the luxury of refusing to do under-mask piercings.

Our Baltimore studio however was still brand new. We weren’t desperate for clients, but we were slower-paced as we worked on building our clientele in a new city. Baltimore, too, felt a major slowdown through the Fall and Winter, and by the time January came around our Baltimore staff was eager to offer nostril and septum piercings. Our Philadelphia staff was still hesitant to offer under-mask services (and Philly had extended the prohibition through mid-January anyway). As we came out of the holiday season we saw business begin to pick back up again, so we again postponed making a decision about our plans for Philadelphia. But we had done the research and with our extensive COVID-19 protocols we felt confident in our ability to offer these services safely, not only for our staff but for our clients as well, and began offering nostril and septum piercings in Baltimore in January of this year.

While we had plans to find a way to not lose one of our Philadelphia piercers when we began offering under-mask services, by the time the Philadelphia health department lifted the restriction on under-mask services again, life had already taken them in another direction and they would soon be leaving the team for other reasons. As with many aspects of this pandemic, there is no one path, or one single answer for every situation. Many challenges must simply be faced on a case-by-case basis, just like this one would have been.

If not now, when?

When to offer under-mask services, and which ones to offer, is a frequent topic among piercers and studio owners on my social media feeds. While many, many piercers quietly offer under-mask services, there are those who loudly and triumphantly virtue signal that “this is the hill they will die on” as they refuse to consider doing any under mask services. Even so, in the smaller piercing-related forums where there are attempts to discuss this in more nuanced terms, there are many who, understandably rather sheepishly, write about offering under-mask services. “If I didn’t, I would be sleeping in my car” one poster wrote, the implication being that it’s the economics of the situation that drives the decision, once again.

And those who trumpet that they will only offer the piercings when it’s safer to do so, when is that going to be? There has been talk about when the transmission rates are at an acceptable level, or hospitalization numbers are manageable, or when vaccination is more widespread—but when exactly is that?

Evolving Circumstances

What we have learned as the months have gone by is that there will most likely be  no easily defined “end” to the pandemic. Rather restrictions will loosen, and things may be different everywhere you go. One county may have entirely different rules then all of the surrounding areas, and every individual and studio will have to make decisions based on their own circumstances—which are always more complicated and complex than they appear on the surface. And just when we get used to the “new normal” we find ourselves facing brand new challenges we hadn’t even thought of yet. For us, we still have many unanswered questions, and like everyone else we will be figuring them out as we go. When will masks no longer be necessary? When will we reintroduce oral piercing services? Will we expand our studio hours to what they were before the pandemic, and if so what will the needs of our staff look like then? What about the COVID-19 variants? How will the vaccine rollout continue to affect…everything?

If we have come through this past year with anything, it’s empathy for anyone and everyone who is responsible for making these tough decisions during this time. Nothing done during this pandemic has been easy, and we (all of us at Infinite) are all feeling the pandemic-fatigue from constantly having to navigate the ever-changing circumstances we keep finding ourselves in. As we all continue to wade through these uncharted waters, we would encourage our industry peers, our clients, and our friends and family, to be compassionate and kind to one another. We have all been operating under extreme circumstances for over a year now. As we slip into managing our own anxiety by sitting in judgement of the actions of others, we should remember that there is always more than what we can see from our vantage point, and for the most part we are all doing the best we can.

Special thanks to Jessica Lewis, Infinite’s Operations Manager, for helping with this post, and for consistently navigating the ship through turbulent waters—until recently with no land in sight. Thanks also to John Logger, Infinite’s Piercing Manager, for always pushing us to take the high road even though it’s most often the much more difficult one. Lastly, thanks to the rest of the staff at for trusting us to be looking out for their best interests when there is so much uncertainty and so little guidance from elsewhere.